The Next Five Years of Change in the NHS Are Crucial to Its Survival

23/03/2015 17:44 GMT
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Updated
23/05/2015 10:59 BST

The NHS was established in 1948. Today it faces its biggest challenge since its inception. A failure to radically reform how we deliver new models of care across the NHS over the next five years could lead to a serious threat to this much-loved public service remaining universal and free at the point of need.

A new report by the Smith Institute released today, Healthcare - The Next Five Years, concludes that change to the NHS is unavoidable, and that political consensus is needed to provide good quality healthcare over the long term.

The various contributors provide details on actions that need to be taken to secure our health futures. However, the most important change of all is how the healthcare system recognises the individual and not just the needs.

The challenges we face are, in large part, due to the outstanding success of the NHS. Indeed, it has a lot to celebrate - it has contributed to people surviving conditions that in the previous century would have been fatal, and has aided an increasing life expectancy.

In MS, it used to be the case that you were simply prescribed steroids and sent away by your doctor. There are now ten Disease Modifying Treatments available on the NHS for relapsing remitting MS.

In the face of widening health inequalities, an ageing population, an increasing number of people living with more than one long-term condition, and the continuing impact of risk factors such as smoking, alcohol, physical inactivity and poor diet, the NHS must change. The pace and scale of change required is unprecedented.

We need to create and foster dynamic, flexible services, focusing on empowering patients, prevention and public health. We need to allow for local innovation and leadership, whilst collectively working towards the outcomes that matter to patients. The most important change, and challenge, is how the health care system mobilises and recognises the assets, strengths and abilities of individuals, not just our needs. The challenge however should not be underestimated.

The vision outlined in the NHS England's Five Year Forward View is a useful starting point, but we should not underestimate the cultural, behavioural and structural barriers to change in this area. Recent skirmishes between providers and NHS England around the 2015/16 tariff are a good indicator of the challenge that lies ahead.

Importantly, we need to recognise that experience of care matters as much to most patients as clinical effectiveness and safety only 50% of people with MS felt that the different people treating and caring for them work well together effectively most or all of the time. Improved A dedicated care coordinator, for example, could improve this statistic dramatically, and I suspect this is true for other long term conditions too. Let's invest in and accurately measure the things patients' value .

Crucially, we need to ensure our care services are up to the challenge, so that we can help to prevent admissions to A&E further down the line. Evidence suggests to the contrary - nearly nine in 10 GPs questioned for a survey said they feared that social care services were not providing sufficient care for patients leading to extra pressure on surgeries and other parts of the health system.

The system must support patients to manage their condition and be at the heart of their own care planning. We are still some way from this becoming a reality - a recent report found that three quarters of people with MS have not been offered a care plan to manage their needs. The next five years will make or break the health service - the Five Year Forward View provides an important opportunity to transform the NHS for the better. Let's work together to make sure the NHS has more to celebrate in the future.